Abstract

Introduction

Cerebral tuberculoma is the most severe form of extra-pulmonary tuberculosis. It is a rare disease representing only 1% of all tuberculosis cases. the authors describe a case of cerebral tuberculoma with atypical radiological aspect initially mimicking a tumor lesion.

Case report (May 12,2017)

A 28-year-old woman, without a specific antecedent, immunocompetent, was originally addressed for an intracranial hypertension syndrome. On admission the patient was apyretic with a general state preserved. The ophthalmological examination found a papillary edema stage II, and the neurological examination was normal. His first cerebral MRI revealed a cortico-subcortical right occipital lesion with an intense enhancement to the injection of gadolinium, producing a serpiginous appearance; we evoqued on an arteriovenous malformation, reason why a cerebral angiography was requested which was normal. A brain MRI Spectroscopy was made afterwards to look for the nature of the lesion, and the spectroscopic aspect was in favor of a malignant glioma. The diagnosis of glioma has been retained, and the decision of surgical excision is taken. But histological examination of the surgical specimen revealed tuberculosis. The patient was treated with anti-tuberculosis drugs. The CT scan shows an occipital porencephalic cavity, it did not show any new lesions.

Conclusion

The diagnosis of intracerebral tuberculoma is based on anatomopathological examination. It must be suspected in front of any single brain lesion.